Fibromyalgia Patients, Lyrica, and Social Security Disability
When I was a disability examiner, I found it fairly common for other examiners to ridicule certain impairments such as chronic fatigue and fibromyalgia. Every time I heard a derisive comment from another examiner about FMS, it would occur to me that if a significant percentage of examiners in all the various disability processing agencies (each state has at least one agency devoted to making disability determinations for the social security administration--in my state, this agency is called DDS, or disability determination services) felt this way, then it was no wonder that fibromyalgia claimants had an uphill battle when it came to filing for disability.
It was probably for this reason that I really sat up and took notice the first time that I saw a commercial for Lyrica, the first drug approved by the FDA for the treatment of fibromyalgia. One thing jumped into my head when I saw the first commercial was this: legitimacy.
Legitimacy is an important concept for disability claims because even though the disability claim process is, on paper, an objective and logical one, in actuality it isn't. The truth is (anyone who has ever worked inside the system knows this) that the system is actually fairly subjective and can be manipulated according to the perceptions and biases of the individuals who work within it, such as examiners, their supervisors, and the medical physicians and psychiatrists who lend support to examiners. For this reason, fibromyalgia claims have probably received short shrift in many cases simply because it hasn't been taken seriously.
Enter the drug Lyrica. Lyrica, whether it turns out to be effective in the long run, or not, provides legitimacy to fibromyalgia cases. Because once you can define a treatment regimen for a condition, the condition receives a measure of validity.
Fortunately, though, the news so far is that Lyrica is effective in reducing pain in fibromyalgia patients (according to the results of three controlled studies involving more than two thousand patients). Notably, the reductions in pain have been associated more with improvements in sleep than with improvements in anxiety or depression.
Why is this significant? Two reasons. First, fibromyalgia has been thought to be linked to sleep deficits. Basically, an inability to achieve enough deep level delta stage sleep may prevent the body from repairing itself, resulting in pain. Second, too many individuals have written FMS off as some byproduct of anxiety and mood disorders. And, yes, I've heard many social security disability examiners make statements to this effect.
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